Provider Demographics
NPI:1578523445
Name:PULMONARY MEDICAL ASSOCIATES PA
Entity type:Organization
Organization Name:PULMONARY MEDICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYYAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-461-4834
Mailing Address - Street 1:1576 SE PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5450
Mailing Address - Country:US
Mailing Address - Phone:772-353-8313
Mailing Address - Fax:772-879-9636
Practice Address - Street 1:1576 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5450
Practice Address - Country:US
Practice Address - Phone:772-353-8313
Practice Address - Fax:772-879-9636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39359207R00000X
FLME30367207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL066226700Medicaid
FL33850OtherBLUECROSS
FL77274AMedicare ID - Type Unspecified
FL33850OtherBLUECROSS